O'Donnell Katherine F
J Perianesth Nurs. 2015 Jun;30(3):221-7. doi: 10.1016/j.jopan.2015.01.013.
The management of pain is one of the greatest clinical challenges for nurses who care for patients during the postoperative period. It can be even more challenging for patients who must manage their own pain after discharge from the health care facility. Research shows that postoperative pain continues to be undermanaged despite decades of education and evidence-based guidelines. Ineffective management of postoperative pain can negatively impact multiple patient outcomes. The purpose of this quality improvement project was to evaluate the effectiveness of a preoperative pain management patient education intervention on improving patients' postoperative pain management outcomes. The project was conducted with patients undergoing same-day laparoscopic cholecystectomy in an outpatient general surgery service at a teaching institution. Patients in the intervention and comparison groups completed the American Pain Society Patient Outcome Questionnaire-Revised during their first postoperative clinic visit 2 weeks after surgery. Results showed that patients who received the preoperative education intervention reported less severe pain during the first 24 hours postoperatively, experienced fewer and less severe pain medication side effects, returned to normal activities sooner, and used more nonpharmacologic pain management methods postoperatively compared with those who did not receive the education.
对于在术后护理患者的护士而言,疼痛管理是最大的临床挑战之一。对于那些在从医疗机构出院后必须自行管理疼痛的患者来说,这可能更具挑战性。研究表明,尽管经过了数十年的教育和循证指南,但术后疼痛仍未得到有效管理。术后疼痛管理不当会对多个患者结局产生负面影响。这个质量改进项目的目的是评估术前疼痛管理患者教育干预对改善患者术后疼痛管理结局的有效性。该项目是在一家教学机构的门诊普通外科服务中,对接受当日腹腔镜胆囊切除术的患者进行的。干预组和对照组的患者在术后2周的首次术后门诊就诊时完成了美国疼痛学会患者结局问卷修订版。结果显示,与未接受教育的患者相比,接受术前教育干预的患者在术后头24小时内报告的疼痛较轻,经历的疼痛药物副作用较少且较轻,更快恢复正常活动,并且术后使用了更多的非药物疼痛管理方法。